A founding physician of now-defunct Forest Park Medical Center in Dallas admitted his role in a $200 million bribery and kickback scheme Oct. 4, according to the Department of Justice.

Wade Neal Barker, MD, pleaded guilty to conspiracy to pay and receive healthcare bribes and kickbacks, as well as aiding and abetting commercial bribery.

The scheme, which began in 2009 and ran through 2013, involved paying surgeons, lawyers and others for referring patients to FPMC, which was out of network with payers. Instead of billing patients for out-of-network copayments, hospital executives and physicians allegedly assured patients they would pay in-network prices. Those involved in the scheme allegedly concealed the patient discounts and wrote off the difference as uncollected bad debt.

Dr. Barker and his co-conspirators allegedly paid $40 million in bribes, funneled through a shell company, to surgeons in exchange for referrals to FPMC. Dr. Barker also received kickbacks because he performed surgeries at the hospital.

There were a total of 21 defendants charged in the scheme in 2016, and Dr. Barker is the seventh to plead guilty. He faces up to seven years in federal prison.